The Influence of Passive Leg Elevation on the Cross-sectional Area of the Internal Jugular Vein in Infants or Young Children Undergoing Open Heart Surgery
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Samsung Medical Center
- Enrollment
- 90
- Locations
- 1
- Primary Endpoint
- Cross-sectional area of internal jugular vein
Study Overview
Brief Summary
The trendelenburg position is usually applied to increase the cross-sectional area of the IJV. However, trendelenburg position requires a tilt table to place the head in the down position. Trendelenburg position could also increase intracranial pressure. Passive leg elevation redistributes more blood from the lower extremity into the central veins and is proved to increase the cross-sectional area of IJV in adults. However, the effect of leg elevation on the cross-sectional area of IJV in small infants and children has not been evaluated.
The investigators evaluated the effect of passive leg elevation on the cross-sectional area of IJV in subjects undergoing open heart surgery for congenital anomaly.
Detailed Description
Internal jugular vein (IJV) cannulation is essential for open heart surgery of small infants and children for transfusion or inotropics infusion. The trendelenburg position is usually applied to increase the cross-sectional area of the IJV.
However, trendelenburg position requires a tilt table to place the head in the down position. Trendelenburg position could also increase intracranial pressure. Passive leg elevation redistributes more blood from the lower extremity into the central veins and is proved to increase the cross-sectional area of IJV in adults. However, the effect of leg elevation on the cross-sectional area of IJV in small infants and children has not been evaluated. Furthermore, the children undergoing open heart surgery due to cardiac anomaly have an altered hemodynamics and often congested right heart. Therefore, the response of passive leg elevation may be different from that of normal heart physiology. Therefore, we evaluated the effect of passive leg elevation on the cross-sectional area of IJV in subjects undergoing open heart surgery for congenital anomaly.
Study Design
- Study Type
- Observational
- Observational Model
- Case Only
- Time Perspective
- Prospective
Eligibility Criteria
- Ages
- — to 5 Years (Child)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •infants or children under 5 yrs undergoing elective open heart surgery for congenital anomaly for study period
Exclusion Criteria
- •previous history of internal jugular vein cannulation
- •concurrent pulmonary disease that can influence the hemodynamics of right heart
- •increased intracranial pressure
- •hemodynamic unstability
Outcomes
Primary Outcomes
Cross-sectional area of internal jugular vein
Time Frame: one time measurement 10 min before jugular vein cannulation
Cross-sectional area of internal jugular vein measured on the ultrasonographic image with planimetry method
Secondary Outcomes
- skin to internal jugular vein depth(one time measurement 10 min before jugular vein cannulation)
- Transverse diameter of internal jugular vein(only one time measurements 10 min before internal jugular vein cannulation)
- horizontal diameter of internal jugular vein(only one time measurements 10 min before jugular vein cannulation)
Investigators
Chung Su Kim
Professor
Samsung Medical Center